Health care’s most underpaid workers

100_4218-2-300x225Vox recently posted an article that frames patients as the health care system’s unpaid workers:

I’m not talking about the work of managing one’s health, the work that diabetics do to monitor their blood sugar or the healthy eating choices a doctor might recommend for an overweight patient. This can be a significant burden in its own right.

What I didn’t understand was the burden patients face in managing the health care system: a massive web of doctors, insurers, pharmacies, and other siloed actors that seem intent on not talking with one another. That unenviable task gets left to the patient, the secret glue that holds the system together.

For me, this feels like a part-time job where the pay is lousy, the hours inconvenient, and the stakes incredibly high. It’s up to me to ferry medical records between different providers, to track down a pharmacy that can fill my prescription, and to talk to my insurance when a treatment gets denied to find out why.

It’s amazing to me that this is the first time I’m reading this characterization of the role of the patient in their own care. It’s true in many areas of health care (as I learned personally last year) and addiction care is no exception.

Getting good care is a lot of work for the patient and requires a lot of time, energy, attention and self-discipline—scarce resources for a lot of patients.

The article does a great job framing just one of the challenges that addiction treatment patients face, especially if they receive care from a provider that does not offer an integrated and complete continuum of care. And, while I view the addiction treatment system as inadequate and deeply troubled, this challenges some of the grass-is-greener-on-the-other-side-of-the-health-care-fence thinking. We frequently hear statements like, “you would never see this with any other patient population.” To be sure, there’s a truth in these statements, but they may be giving the health care system too much credit.

Maybe we can take a little consolation in the idea that we’re not quite as alone as we may have thought in the challenges we face.

Maybe addiction care can play a role in improving health care in general.

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